[CIS PIDD] [cis-pidd] Yellow Fever Vaccine in sIgAD

[Yeşim Yılmaz Demirdağ]

Dear all,

I would like to bring the "Yellow Fever vaccine and IgA deficiency" topic
back to the group discussion. Last discussion concluded that YF vaccine is
not contraindicated in IgA deficiency.

I received an e-mail today from a colleague. His patient, a 25 yo woman
with history of Grave's disease, is planning to visit Ghana and she needs
Yellow Fever vaccination. She had slightly low IgA and IgM 3 years ago
(checked during Grave's work-up). She does not have recurrent infections
and she is otherwise healthy. She and her father contacted CDC and were
told that YF vaccine is contraindicated in selective IgA deficiency and
they were given this reference
http://www.cdc.gov/mmwr/pdf/rr/rr6002.pdf (Table 13 on page 48). I was
not aware of this publication, so I wanted to
let you all know about it and ask your opinion.

Back to the patient: Her recent IgA level is 49 mg/dl (70-312), IgM is 43
mg/dl (56-352) and IgG is 913 mg/dl (639-1349).  I am not impressed by
these values. But the family is reluctant. What would you recommend for
this patient? Does she have selective IgA deficiency? What about slightly
low IgM? Do you think this combination should be a contraindication for the
vaccine?

Dewton, you mentioned that YF vaccine is widely used in inland Brazil. Do
you have any data on the frequency of IgA deficiency in patients who
developed severe reaction to this vaccine?

Thank you,

Yesim



Yesim Yilmaz Demirdag, MD
Assistant Professor of Pediatrics
Division of Allergy and Immunology
Columbia University Medical Center
New York








On Wed, Jun 19, 2013 at 1:13 PM, Church, Joseph <JChurch at chla.usc.edu>wrote:


>  Colleagues:****

>

> ** **

>

> A 20+ year old patient is traveling to Africa and is recommended to

> receive Yellow Fever Vaccine.****

>

> ** **

>

> She has selective IgA deficiency.  Assuming she does not have an antibody

> deficiency is there a contraindication to giving  her the YF vaccine?****

>

> ** **

>

> Joe Church****

>

> Children’s hospital Los Angeles****

>

>

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